A Modified Pressure Dressing to Avoid Severe Bleeding After Circumcision With a Disposable Circumcision Suture Device and a Discussion on the Mechanism of Bleeding With the Disposable Circumcision Suture Device.

INTRODUCTION: A novel type of a disposable circumcision suture device (DCSD) has been proved to be effective and safe; however, a few cases of severe bleeding took place after circumcisions. AIM: To evaluate the effectiveness of a modified double-layer pressure dressing to avoid severe bleeding after circumcision with the DCSD, in our department in a prospective randomized controlled study, and discuss the mechanism of bleeding with DCSD. METHODS: Patients with redundant foreskin or phimosis were included between September 2018 and November 2019 and divided into 2 groups: In group A, the conventional pressure dressing was performed; in group B, an modified double-layer pressure dressing was performed. MAIN OUTCOME MEASURE: The main outcomes and complications (surgical time, incidence of glans ischemia, severe bleeding rate, infection rate, pain level, total cost, and overall satisfaction) were collected and analyzed. RESULTS: A total of 624 patients were recruited for this study. There was no difference in the average age and body mass index between 2 groups. No patient suffered obvious glans ischemia. In group B, lower pain level, lower incidences of severe bleeding, and better satisfaction were recorded. CONCLUSION: The mechanism of bleeding with the DCSD was discussed in this study, and the modified pressure dressing was proved effective, safe, and easy to perform. W Jiang, J-li Fu, W-l Guo, et al. A Modified Pressure Dressing to Avoid Severe Bleeding After Circumcision With a Disposable Circumcision Suture Device and a Discussion on the Mechanism of Bleeding With the Disposable Circumcision Suture Device. Sex Med 2021;9:100288.

Therapeutic effect and adverse reaction of sorafenib in the treatment of advanced renal cancer.

Efficacy and safety of sorafenib in patients with advanced renal cancer were evaluated. Seventy-four patients with advanced renal cancer treated with sorafenib + interferon from January 2010 to August 2013 were included as the observation group. Another 53 renal cancer patients treated with interferon alone were included in the control group. Clinical data of those patients were retrospectively analyzed. Treatment plan: initial dose was 400 mg, twice a day. Additionally, patients in the interferon group were treated with another 300 MU every other day. Efficacy was evaluated according to RECIST criteria, and progression-free survival (PFS), overall survival (OS), and incidence of adverse reactions were recorded. In the observation group, a median OS was 15.3 months (range, 9-60 months), and a median PFS was 8.2 months (range, 2-36 months). There were 4 cases of complete remission (CR) (5.41%), 16 cases of partial remission (PR) (21.62%), 42 cases of stable disease (SD) (56.76%), 12 cases of disease progression (16.22%), and disease control rate (DCR) was 83.78% (62 cases). In the control group, median OS time was 12.5 months (range, 8-60 months), and the median PFS time was 9.3 months (range, 2-40 months). There were 2 cases of CR (3.77%), 11 cases of PR (20.75%), 20 cases of SD (37.74%), 20 cases of disease progression (37.74%), and DCR was 62.26% (33 cases). Disease control rate in the observation group was significantly higher than that in the control group (P<0.05). Main adverse events in the groups were skin reaction, fever, diarrhea, fatigue, rash, loss of appetite, hypertension, hair loss and liver function abnormality. Sorafenib-based targeted therapy for the treatment of advanced renal cancer has a higher rate of disease control, and the adverse reactions are controllable and tolerable.

Correlation study of chronic nonbacterial prostatitis with the levels of COX-2 and PGE2 in prostatic secretion.

OBJECTIVE: The prostatitis syndrome is a multifactorial condition of largely unknown etiology. This study is to analyze the relationship between cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) with the chronic nonbacterial prostatitis (CNBP). METHODS: A total of 172 CNBP patients and 151 healthy males were recruited as CNBP and control group, respectively. The prostatic fluid was collected and tested by pre- and post-massage test. White blood cell (WBC) number was counted, and the contents of COX-2 and PGE2 were determined by double antibody-based sandwich enzyme-linked immuno-sorbent assay. The pain and discomfort of each patient were scored according to the National Institutes of Health chronic prostatitis symptom index. RESULTS: Compared with the control group, CNBP group displayed significantly higher WBC count, COX-2 level, and PGE2 level. Contents of COX-2 and PGE2 in prostatic secretion of CNBP group were positively correlated with pain scores (r = 0.855 and 0.675, respectively, P < 0.01) and total symptom scores (r = 0.674 and 0.566, respectively, P < 0.01). A significantly positive correlation between COX-2 and PGE2 levels was also discovered (r = 0.493, P < 0.05). The WBC number was not obviously correlated with the accumulations of COX-2 and PGE2 or the clinic symptoms of CNBP. CONCLUSION: Increase in PGE2 concentration caused by activated COX-2 pathway may contribute to the pain or discomfort symptom of the CNBP patients. Our results indicate that selective COX-2 inhibitors have application prospect in CNBP treatment.